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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • parotitis prophylaxis is important the principles are:
    • adequate fluid intake
    • avoidance of anti-cholinergics
    • good oral hygiene, i.e. frequent gargles, mouth irrigation, other mouth cleansing and moistening measures
    • stimulation of salivary flow by chewing gum may be of benefit

  • in acute suppurative parotitis the treatment consists of:
    • stringent oral hygiene
    • key in the treatment of acute suppurative parotitis (ASP) is rehydration (may require intravenous fluids)
    • most cases of ASP due to Staphylococcal aureus, the first drug of choice should be an initial empirical treatment with an antistaphlylococcal penicillin e.g. flucloxacillin, co-amoxiclav. Antibiotic treatment is continued for 10 to 14 days
    • if there is failure of medical management then surgery should be considered
      • surgical intervention e.g. incision and drainage of the gland, may be indicated if:
        • lack of improvement after 3 to 5 days of antibiotic therapy,
        • facial nerve involvement,
        • involvement of adjacent vital structures (lateral pharyngeal space, deep fascial spaces),
        • frank abscess formation within the gland parenchyma
    • also there is support for surgical intervention in the form of superficial parotidectomy for patients with ASP in whom chronic recurrent parotitis then develops

Reference:

  1. Fatahhi TT et al. Management of acute suppurative parotitis. J Oral Maxillofac Surg. 2002 Apr;60(4):446-8.

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